Barbershop-Managed Hypertension

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Non-hispanic black men have a higher rate of hypertension-related death than any other racial group in the US.

In a recent study involving 52 black-owned barbershops in the Los Angeles area, barbers encouraged their regular black male customers (35 – 79 years old) to get their blood pressure (BP) checked at the shops. Uncontrolled hypertension (systolic BP = 140 mmHg) was found in 319 men. These men were then followed up in the shops by either 1) specialty-trained pharmacists working under a collaborative practice agreement to manage hypertension (intervention group; n=139), or 2) barbers who provided information about BP management, including lifestyle changes and follow-up provider appointments (control group; n =180). Both groups were given resources to promote staying in the study (eg, follow-up calls, vouchers for monthly haircuts).

In the intervention group, tensives, measured BP, encouraged lifestyle changes, and monitored electrolyte levels. Treatment with amlodipine plus an angiotensin receptor blocker or angiotensin converting enzyme inhibitor was used for most men; indapamide was added if needed.

At 6 months, the average systolic BP was lowered by 27 mmHg (from 153 mmHg) in the intervention group, and by 9.3 mmHg (from 155 mmHg) in the control group. Blood pressure less than 130/80 mmHg was achieved by 64% of the intervention group and just under 12% of the control group.

The study is currently being extended to assess sustainability. Thus far, the results show that creative methods may be effective for improving health – especially among at-risk individuals who are not plugged into a healthcare system.

• Victor RG, et al. N Engl J Med 2018; 1291-1301.

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